Online Shopping for Birth Control: An NWHN Guide

Background

The NWHN believes that every person—women, men, and gender-nonconforming folks—have the right to manage their own sexuality on their own terms, including when it comes to birth control. Websites now make online access to birth control a convenient and easy way to get your preferred method. But, online shopping for anything can be confusing—and online shopping for prescription birth control is no different.

The NWHN cares deeply about health care quality, medication safety, and the right of all people to have accurate information they can use to make informed decisions about their health care. We have an extensive history of advocating for family planning providers to incorporate these values and offer client-centered reproductive health care. So, we welcome innovations like online birth control access in order to help people get the health care they need in ways that are both convenient and affordable.

The NWHN offers this guide to ensure that you’re well-informed as you navigate online birth control sites. We visited a handful of websites offering a variety birth control options—Alpha, Lemonaid, Nurx, Pandia Health, The Pill Club, and Simple Health—and examined how well they meet the NWHN’s values. Below, we outline how these sites compare to one another and offer some suggestions that may help you decide what birth control and website to use.

One note: Lemonaid is the only site advertising that it is able to serve patients in all 50 states. We found that other sites frequently update the states they’re able to serve. It’s worth trying again if you like a site that isn’t able to serve you the first time you contact it.

Availability of a Range of Options 

  • Sites have a range of available birth control options. Each of the websites we visited offer hormonal contraception, but not all offer the full range of options. Ideally, we would like to see a list of all methods offered, including oral contraceptives (OCs, or “the Pill”), the shot, the two contraceptive patches, the monthly contraceptive ring (NuvaRing), and year-long ring (Annovera). One site, Pandia, came close to our ideal, stating that it can prescribe all brands of contraception. Other websites provided full lists of the types of OCs offered, but either only offered one type of patch or ring, or didn’t offer either of the contraceptive patches. But, if you know exactly which type of contraceptive you want to use, a site with limited options might be okay for you.
  • If you know you want to use oral contraceptives, Simple Health can provide more than 100 brands. Lemonaid, Alpha, and the Pill Club also lists the brands of OC they carry. Pandia lists the most popular brands on its site. On the other hand, Nurx doesn’t provide any information about OCs until after a customer creates an account on the website, which is a barrier for shoppers who are mainly seeking information. Having many OC options to choose from is important because, while all versions of the Pill are equally effective, some people respond better to one version or another. Further, pills containing drospirenone (Yaz, Yazmin, Beyaz, Nikki, Loryna) and desogestrel (Apri, Isibloom, Juleber, Velivet) have slightly higher rates of risk of developing blood clots, a very rare but serious complication of hormonal contraceptives.
  • If you know you want to use a contraceptive ring, Pandia, Simple Health, Nurx, and Alpha all carry the monthly ring (NuvaRing). The Pill Club, Alpha Simple Health and Pandia also carry the year-long ring (Annovera). The NWHN advises people to try the monthly version first if you’re never used a contraceptive ring before.
  • The new low-dose contraceptive patch (Twirla) became available shortly after we explored the sites. It’s not included in the chart below, but it’s likely that online sites will start carrying it soon. If you’re a satisfied user of the original contraceptive patch (Xulane), which contains a higher dose of hormones than Twirla, you can obtain Xulane on Alpha, Pandia, Simple Health and Nurx. If you’re interested in trying the contraceptive patch for the first time, we recommend starting with Twirla, as its lower dose of hormones reduces the (rare) risk of blood clots.
  • The new contraceptive gel (Phexxi) was also not mentioned by any of the sites we visited. It’s a good option for people who want to use a non-hormonal method, but unlike other contraceptive gels it requires a prescription.  We hope to see it available online soon.
  • Nurx and Alpha also offer the contraceptive shot (Depo Provera). Not everyone is comfortable giving themselves an injection, but for those experienced users who are okay with it, ordering online can be a good option.

Interacting with the Provider 

  • An online prescription for birth control must be approved by a nurse practitioner, a physician, or another clinician who has the authority to write prescriptions. Who you interact with, and how much you interact with the clinician who approves your prescription depends on where you live. All of the sites we visited are organized to provide care via privacy-protected online interactions—meaning you answer some questions online and a clinician reviews your information later on. However, some states require prescribers to have a phone call or video chat with a consumer before issuing a prescription. Regardless of how your interaction happens, you should always be given the full name of the clinician who approved your prescription.
  • If you want the option to have personal interaction with a provider via video, regardless of where you live, try Lemonaid. Each video consultation with a clinician costs $75.
  • Both Simple Health and Pandia Health have a chat function on their websites for 24/7 access.

Access to Additional Health Services

  • If you would like to add a form of Emergency Contraception to your monthly birth control order, take a look at Alpha, Nurx, and The Pill Club.
  • Along with birth control services, Simple Health, Alpha, Lemonaid, and Nurx offer additional sexual health treatments and medications. Alpha, Lemonaid, and Nurx offer at-home testing kits for sexually transmitted infections (STIs) and prescriptions to treat several STIs, including genital herpes, chlamydia, and gonorrhea.
  • Lemonaid and Alpha also offer treatment for erectile dysfunction, endometriosis, migraine, acid reflux, hypothyroidism, hair loss, skin infections, and acne. They also offer mental health treatment, but the NWHN recommends seeing an experienced mental health professional first, to decide what is the best course of action for your specific needs.

Language Options

  • Pandia is the only website that offers a phone number for Spanish speakers to call.

Warning: Distractions!

  • It’s common for websites to promote specific brands because they have a financial incentive; this is one way they make more money. Both Lemonaid and Simple Health’s websites have such promotions. It is important for consumers to make choices about their health care without being subjected to distractions or biased influences that benefit the online company rather than the consumer.

Resources

If you’re not sure which method is right for you, there are several great sources of information that can help you learn about new methods, and think through which features of a method are most important to you. A health professional can give you advice about the medical aspects of contraception, but only you know how important other issues, such as spotting or wearing a visible method, are to you. Here are a few sources that present information in an unbiased way: